Conditions: Eyelid ptosis Children 2017-10-12T16:35:33+00:00

Eyelid ptosis (Children) Overview

Talk to us about your current condition on:
020 7935 7990

The best way to figure out whether your specific condition can be treated or not is to give us a call. We can answer any questions you have and help you clarify which treatment options might be suitable for you.

There are different treatment options available for this condition and the most common ones are listed below:

  • Brow suspension

  • Strengthening Procedure

Learn more about treatment options

Eyelid ptosis (Children)

What is an Eyelid ptosis (Children)?

Eyelid ptosis in children is usually due to a congenitally fatty muscle that lifts the lids – as a result the muscle is not strong enough and the eyelid droops. If not treated promptly, the condition can result in permanent visual impairment.

 

Treatment

The only way to treat this condition is by performing surgery to lift the eyelid.

The options include:

  • A brow suspension which allows the child to raise the eyelids by raising their eyebrows. In children with congenital ptosis we use different suspension materials to join the weak eyelid to the frontalis muscle in the forehead, so when the brow is raised, the eyelid is as well. In this procedure, a special suture is used (eg. Goretex® or Prolene®) or some tissue is transferred from the leg.
  • A strengthening procedure on the levator muscle (see below) via the skin crease or posterior incision.

Unless the ptosis is imparing the child’s vision, it is generally preferable to wait until the child is 3 or 4, as the results are usually better. However, if the eyelid covers the pupil, the risk of “lazy eye” is much higher so the surgery is more urgent and can be done from as young as three weeks.

Video: What is ptosis and how can you treat it?

Examination for Eyelid ptosis (Children)

A full ophthalmic examination is performed to check visual function, eye movement, the eyelids and the ocular surface. Then a full face examination is performed. It is common for photographs to be taken. Special eyelid measurements are taken to assess the degree and type of ptosis. This helps decide the specific surgery that may be required.

In children it is particularly important to assess if the drooping eyelid is causing visual impairment (amblyopia), as, when this is the case, it must be treated as soon as possible.

The child’s vision and eye movements are assessed with the help of an orthoptist. It may be necessary to check if glasses are required using drops and a refraction test.

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“Just keep up the good work Dr Khan. My wife, who accompanied me, and I were both very impressed by the care and consideration shown by the whole team when I had surgery. I just hope they haven’t lost the knack by the time I get my other eye fixed. joking apart the care of this team has made it a wonderful experience for me.”
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“Dear Dr. Michaelides, I just wanted to express mine and my parents gratitude for arranging to see us all today and taking the time to answer all our questions. We left with a much greater understanding of the issues involved with genetic testing, the potential pattern of inheritance I have, and a renewed optimism over advances that could be happening in the field. It was also very helpful and reassuring to see Dr Amar again and be introduced to Jonathan the genetic counsellor – please do pass on our thanks to them as well. Yours sincerely Rachael S.”
Rachael S.
“Dear Professor Michaelides ,
Well done and thank you! You saw me last November for my annual RP assessment. You recommended to see the Glaucoma unit which I duly attended last week. (There was a delay because I had a cataract op in February)I do indeed have glaucoma as well as RP. Thankfully glaucoma is likely to be treatable with drops, so now at last the deterioration in my sight may be least partially arrested. I hope you will recommend to the retinal team that all RP suffers are tested for Glaucoma at fitting intervals. Yours sincerely, Edmund S.”
Edmund S.
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On behalf of my mother as well as myself, I would like to thank you for the consultation we had with you last Friday regarding my Usher Type 2/ RP condition. The knowledge and advice you shared with us was much appreciated. Today I received copy of the letter which you sent to my GP as record of the consultation. You might recall I mentioned that I have and indoor cycling frame which is great for an ex-road cyclist. If you should have any other patients who have to give up cycling on the road, I can recommend the “e-motion rollers” which is an American product and allows cyclists to ride their actual bike without modifications – suitable only for road bikes with high tyre pressure. Kind regards, Chris B.”
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David
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Maurice K.
“Mr. Reddy was extremely kind and his special ‘duck’ noises certainly helped catch Talia’s attention and helped his examination run smoothly. Mr. Reddy informed us that Talia’s squint was severe and that glasses would not help her. He explained that she would need surgery. We have recently seen Mr. Reddy and the Orthoptist for a follow up and everyone involved is really pleased with the results of the surgery, most of all it seems is Talia.”
Rebecca and Daniel Corney
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Fiona M.
“Dr Crawley is always in such a good mood and always does her utmost to help. Best doctor I have ever seen!”
Matthew K.
“Dr Crawley has a wonderful manner, is clearly knowledgeable and is an asset to the hospital.”
Lisa A.
“Thank you for forwarding the medical report. Please convey my thanks to Jane, I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon.”
Jeffrey W.
“Dear Jane,
I just wanted to say thank you for seeing me at such short notice. I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.
I would also like to thank Ingrid, who was so lovely and very professional.
Best wishes, Catherine M.”
Catherine M.
“Thank you for forwarding the medical report. Please convey my thanks to Jane, I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon. Jeffrey W.”
Jeffrey W.
“I highly recommend Jane Olver. The whole experience was calm,and highly professional..”
Lorraine M.

“Dear Both,

Many thanks for taking care of my ptosis surgery today.
I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.

Many thanks, Charmaine”

Charmaine

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Frequently Asked Questions

Eyelid ptosis surgery is usually performed as a day case and will not require an overnight stay. For children, the operation is performed under general anaesthetic.

The oculoplastic surgeon makes a few very small incisions in the eyelid and over the brow, and then passes the suspension material through the incisions to join the eyelid with the forehead. The small incisions are closed with discrete stitches.

Under general anaesthetic no pain will be felt. After the operation they will feel a little discomfort around the eye but this usually settles within a few days.

The operation can also be done under local anaesthetic where just the forehead or eyelids are injected and are pain-free.

The oculoplastic surgeon does not usually pad the eye after a frontalis suspension as the eye stays open and the pad could scratch the eye.

At the end of the operation the oculoplastic surgeon puts a lot of antibiotic ointment on the eye to protect it. Post-operative care consist of applying antibiotic ointment to the eye and wound 3 or 4 times a day and painkillers for any pain or discomfort.

Initially the eyelids are often bruised and swollen. The bruising can take 2-3 weeks to clear and there may be some residual swelling for up to 6 weeks.

It often takes several months for the lids to settle into their new position, and only then can the effectiveness of the surgery be assessed. The scars will fade gradually, but in any case are very small and tend to be hidden within the crease of the eyelid.

One risk of a frontalis suspension is asymmetry between each side requiring further operations, sometimes a few years later.

Other, rarer complications can include:

  • Infection of the material (if this happens the surgeon makes an operation to remove the infected material)
  • Extrusion of the material (sometimes another operation is needed to remove/replace the material)
  • Difficulties in closing the eye properly. This is helped by lubricant eye drops and only very rarely is a further operation required.